ENDOCARDITIS ■ 83 



injections of oil of camphor. Where fever is present, 

 acetanihd (gj) or salicylate of soda (5j to ij) may be tried. 



Chronic iSndocarditis. — ^Etiology.— Occurs in the dog, horse, 

 swine and ox in frequency in the order named. It usually 

 follows acute endocarditis (septicemia, articular rheumatism 

 of the ox, influenza of the horse, erysipelas of swine and 

 hog-cholera). Otherwise the disorder may develop gradually 

 following the abuse of the heart (overexertion, refrigeration, 

 psychic influence). ' In animals it is rarely due to arterio- 

 sclerosis. In rare instances valvular troubles may be con- 

 genital (defects in the valves, oval foramen, or septum). 

 Tumors leading to stenosis of the ostia are rare causes. 



Pathologically valvular troubles lead either to insufiBciency 

 or stenosis of the. valve or ostium concerned. Commonly 

 these are combined. 



General Symptoms. — ^The clinical features of valvular dis- 

 ease may be divided into two stages: {a) The stage of 

 compensation, and (6) the stage of disturbance in compensa- 

 tion. 



(a) From a resulting compensatory hypertrophy the 

 trouble with the valve may be for a long time overcome. 

 Clinically no symptoms exist other than either a systolic 

 or diastolic murmur with hypertrophy of the left or right 

 heart. The general condition and efficiency of the patient 

 are not much disturbed. 



(6) In the stage of disturbance in compensation the com- 

 pensatory hypertrophy has been partially or totally overcome. 

 Dilatation displaces hypertrophy. This induces symptoms 

 of heart weakness. The pulse becomes fast, weak, inequal 

 and irregular. The patient is dyspneic, especially after 

 exercise, from a resulting congestion of the lungs. The 

 mucous membranes and skin are cyanotic, and undulation 

 of the jugulars is noted. The patient may show vertigo, 

 especially when the head is elevated as in drenching, and drop 

 to the ground. In the later stages symptoms of general 

 dropsy appear (anasarca, ascites, hydrothorax, hydroperi- 

 cardium). The animal loses flesh, is weak and anemic. The 

 urine may contain albimiin (albuminuria from congestion of 

 the kidneys). 



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